Efficacy of dexmedetomidine used to supplement lumbar plexus combined with sciatic nerve block for total hip arthroplasty in elderly patients
10.3760/cma.j.issn.0254-1416.2012.12.009
- VernacularTitle:右美托咪定用于老年患者腰丛联合坐骨神经阻滞下全髋关节置换术的辅助效果
- Author:
Yongkang CUI
;
Bing TIAN
;
Jing WANG
- Publication Type:Journal Article
- Keywords:
Dexmedetomidine;
Elderly;
Combined lumbar plexus-sciatic nerve block;
Arthroplasty,replacement,hip
- From:
Chinese Journal of Anesthesiology
2012;(12):1449-1452
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy of dexmedetomidine used to supplement lumbar plexus combined with sciatic nerve block for total hip arthroplasty in the elderly patients.Methods Fifty ASA Ⅱ or Ⅲ patients,aged 80-93 yr,with a body mass index of 17-25 kg/m2,scheduled for unilateral total hip arthroplasty,were randomly divided into 2 groups (n =25 each):normal saline group (group NS) and dexmedetomidine group (group D).Lumbar plexus combined with sciatic nerve block was performed guided by a nerve stimulator in both groups.After a loading dose of dexmedetomidine 0.5 μg/kg was infused over 10 min starting from 20 min after the block,dexmedetomidine was infused at 0.2 μg· kg-1 · h-1 until the end of surgery.While the equal volume of normal saline was given instead of dexmedetomidine in group C.Propofol 20 mg or ketamine 10 mg was infused intravenously when the efficacy of the block was inadequate.The mean arterial pressure (MAP),heart rate (HR),pulse oxygen saturation (SpO2),respiratory rate (RR),side effects during operation,requirement for propofol or ketamine and doctor' s satisfaction were recorded after admission to the operating room,immediately after iv administration,at 0,10 and 30 min after the beginning of surgery,and at the end of surgery (T0-5).Results Compared with the baseline value at T0,MAP and HR were significantly increased at T2-5 in group C (P ＜ 0.05),and no significant change was found in the hemodynamic parameters at each time point in group D (P ＞ 0.05).Compared with group C,the MAP,HR,incidences of respiratory depression and agitation and requirement for propofol or ketamine were significantly decreased,and the doctor's satisfaction was significantly increased (P ＜ 0.05).Conclusion Dexmedetomidine can increase the efficacy of lumbar plexus combined with sciatic nerve block when used for supplementation of total hip arthroplasty in the elderly patients,the hemodynamics is stable and side effects are fewer.
